UNLABELLED Firearm instructors represent a particular occupational group exposed to low lead (Pb) doses. Even low blood lead levels (PbB) of this metal can cause an increase of blood pressure (BP). OBJECTIVE To assess the Pb exposure of the firearm instructors of the Italian State Police (SP) and the effects of Pb on their PA. SUBJECTS AND METHODS 376 instructors were studied, including 188 subjects working at indoor and 188 at outdoorfiring ranges. After obtaining informed consent, information on work, social and pathological history was collected and measurements of body mass index (BMI), BP and blood lead (PbB) level were obtained from the medical records. RESULTS The mean PbB level of the instructors of outdoor ranges (6.7 +/- 5.3 microg/dl) was significantly lower than those of indoor ranges (8.5 +/- 7.6 microg/dl). In the instructors of outdoor ranges the diastolic BP (DBP) was significantly influenced by BMI and PbB, also considering the common confounding factors. DISCUSSION The mean PbB level of the firearm instructors of the Italian SP resulted to be clearly below the biological limit value for Pb. In the instructors of outdoor ranges the even low PbB levels detected were able to determine a slight, but significant increase of DBP, also after correction for the main confounding variables. It is therefore necessary to keep on effecting biological monitoring and health surveillance of firearm instructors of SP and to promote the reduction of their body weight.